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Transcript of Connecting Retail Clinics and Pharmacies to the Medical … · CVS Retail Pharmacy ... •Pharmacy...
©2010 Caremark. All rights reserved. This presentation contains confidential and proprietary information of
CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Caremark.
©2010 Caremark. All rights reserved. This presentation contains confidential and proprietary information of
CVS Caremark and cannot be reproduced, distributed or printed without written permission from CVS Caremark.
Connecting Retail Clinics and
Pharmacies to the Medical Home
HIMSS Meeting
Cisco Customer Forum
February 2014
©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
A Pharmacy Innovation Company
Fortune 13 company: Resources and capital to innovate
to improve care for our patients
CVS Retail Pharmacy 7,400 stores, 5 million served daily
69M households with ExtraCare® card
CVS Caremark PBM 2,000 clients, 63M members, including 6M Med D, 8M Medicaid 35M web visits in 2012
MinuteClinic® 800 clinics, 17M patients
served, affiliated with 27 major health systems– moving to 1800 clinics by 2017
Mail Service Pharmacy
2 mail service pharmacies 50M+ scripts annually
Specialty Pharmacy
through 7,400 CVS retail pharmacies, 12 mail service
pharmacies, therapy- specific CareTeams
Clinical Innovation Accordant Health Services Genetic Benefit Management Pharmacy Advisor®
Behavior Change Research
27080
©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
We Are Evolving into Connected Health As a
Pharmacy Innovation Company
Old Metaphor
• Pharmacy only did
pharmacy
• Pharmacist only filled
prescriptions
• Pharmacy was
unconnected from the total
cost of care
• Pro-active outreach to
providers happened
infrequently, by telephone
New Metaphor
• Pharmacy now provides
range of care
• Pharmacist advises and
counsels patient
• Pharmacy can drive
business insofar as it helps
address cost of care
• Pharmacy information
must travel seamlessly
electronically to other
providers
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©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Landscape of Provider Connectivity
• There is increasing concentration in the Electronic Medical
Record (EMR) industry, especially among organized
providers
• Key competitors include: Epic, Eclinical Works, Allscripts,
Cerner, GE Centricity, NextGen, Athena, Greenway
• For exchange of data there are several flavors:
– Surescripts for prescription information
– Bidirectional Work Flow vendors– Relay, Medicity, Siemens
– Enterprise HIE developers– dbMotion, Relay, Axolotl, Medicity
– Clearinghouses and other Portals– Navinet, Availity, CVSC
– New EMR Collaborations: Commonwell
– Home grown Neural Networks for PCMH– iCentric, Cozeva
• Meaningful Use 2 is driving new attention to connectivity
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©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Increased Connectivity Improves Patient Care
5
Patient
Minute
Clinic
Affiliated
Health
System
Patient Presents At
MinuteClinic
Nurse Practitioner Accesses
MinuteClinic EMR
Health System Patient Notes:
• Allergic to Penicillin
• Current medications
• Hypertension: needs BP check
MinuteClinic EMR Link
To Health System
Nurse Practitioner
Treats Patient
Electronic Clinical
Information Exchange
1
2
3
4
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©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Minute Clinic Connected to Health System
Connectivity Advantages
•Create virtual “medical
neighborhood”
•Share clinical data
•Enhance quality of care
•Reduce duplication, expense
MinuteClinic EMR
Health system patient record Integrated
©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Data Integration Integration Of Electronic Medical Records
With Health Systems
Read 09/25/2010 Labtest, Labfour Retail Clinic Visit Provider,External... Closed
CCF Department
Scanned Documents
View Retail Clinic Visit - CVS Strongsville 09/25/2010 ]
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©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Minute Clinic Currently Relies On Surescripts
• Surescripts acquired Kryptiq to allow it to move data on the
Surescripts network
• Minute Clinic approaches each affiliate about how and
what information to share, with no two affiliates being
exactly alike from an IT or legal/privacy perspective
• Legal issues seen as distinct by each affiliate
• Pace is beginning to pick up last few months after some
substantial successes over the past three years with
minimal investment
• Question is which is the best path?
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©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Alternative Methods for Connectivity
• Use a highly prevalent EMR and rely on inter-company
connectivity– Epic or Athena play
• Rely on HIE’s to develop and use them to deliver notes and
data– Do they have a business model?
• Presume that more EMR’s will open their architecture to
allow more data exchange--- Is the CommonWell Alliance
for real
• Expect bidirectional work flow or Enterprise HIE connectors
to evolve into full format inter-enterprise connectors– Are
Relay, Medicity, dbMotion and Axolotl serious alternatives?
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©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Health Information Tags:
We Provide Information to Medical Homes, and Deliver
Messages on Behalf of Medical Homes
PCMH Directed Access frequent patient
touch points
Health Information Tags
Takes Advantage of Convenient,
High Contact Pharmacies
and Clinics Pharmacy based
clinical targeting
PCP, Care Teams
Care Coordinators
Prescribers
©2013 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. 11
HMSA (BCBS of Hawaii)
has developed an advanced
medical home program
All Clinical Messaging Will Be
Pulsed through Cozeva Neural
Network
Pharmacy Benefit Data to Support Patient Care
• Delivering messages to Cozeva Based on PBM Analytics
• Maintenance Choice Voluntary
• Brand to Generic
• Gaps in Care
• Adherence to Medications and Vaccine Reminders
• Working closely with HMSA and ARW (Cozeva developer)
©2013 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. 12
CVS Caremark Messaging Integrated in Cozeva
©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Interactive pharmacy analytics tool supports
ACO and Health Plan Medical Home Strategy
• Identify ACO or PCMH members for cost-savings, adherence outreach and therapy changes
− “Who does my case manager need to reach out to today to improve adherence?”
− “Which patients can switch to a generic to lower costs?”
• Plan-, PCMH-, or practice-level views
• Drill-down reporting for physicians and nurse/case manager
Pinpointing high-value patient outreach
Sample report: Report specifics subject to change
27046
©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
Health Information Tags: Pharmacist Responds
to Provider Messages/Requests
• Diabetes
– A1C tests
– Blood Glucose Monitoring
– Eye Exam
– Foot Exam
• Cardiovascular
– Blood Pressure Check
– Cholesterol Test
• Plan Benefit enrollment
– MTM programs
• Vaccinations
– Flu, Pneumonia, Shingles
• Wellness “Gaps”
– Cholesterol or Asthma
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Pharmacist Informs Patient that Specific Test is
Needed– Next Step Will be Referral to Minute Clinic,
or Point of Care Lab Testing
©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark. ©2010 Caremark. All rights reserved. CVS Caremark proprietary and confidential information. Not for distribution without written permission from CVS Caremark.
• Leverage industry-leading technology to help improve
the coordination of care
• Large scale pilot from one Minute Clinic to another begins this Fall, with
key being load leveling
• Will rapidly expand to new applications :
− Connect MinuteClinic® providers directly
with physicians
− Enable physician consultation for members
in rural areas or without adequate access
− Facilitate patient consultations at employer
locations
Future Innovations: Telemedicine
Further expanding access to primary health care